How to Care for and Cope With a Bipolar Spouse

If you're involved with someone with bipolar disorder, the romantic relationship may be exciting, exhausting, and stressful. But it will rarely be easy, especially if the object of your affection doesn't comply fully with treatment.

Bipolar disorder can be nearly as traumatic for the partners of those with the disorder as it is for the patients themselves. The episodes of depression and mania that bipolar people experience—which can lead to emotional withdrawal, out-of-the-blue accusations and outbursts, spending sprees, and everything in between—have been shown to induce stress, sexual dissatisfaction, and money worries in their partners, as well as depression. Depressive phases, during which the bipolar partner feels hopeless and sad, can drag a healthy partner down, too.

"Mental illness is, on some levels, a contagious disease," says David Karp, PhD, a professor of sociology at Boston College who has studied interpersonal dynamics within bipolar couples. "It brings out very strong negative emotions and feelings of isolation in the partner, who struggles so hard to separate the illness from the patient."

Relatively few studies have been conducted on the effects of bipolar disorder on relationships, but the research is nearly unanimous that the disorder tends to cause both practical and emotional difficulties for couples.

For starters, the ups and downs of bipolar disorder can disrupt the rhythms and routines of a household. In a 2005 survey of people with bipolar partners published in Bipolar Disorders, more than half of the participants reported that their partners illness had reduced their socializing, required them to assume more household responsibilities, forced them to take time off of work, and caused financial strain. The participants also reported that their sex lives sagged when their partner was in a manic or a depressive phase; three-quarters of the women who were interviewed and 53% of the men complained of infrequent sex when their spouses were depressed.

Another study of bipolar caregivers found that 86% of the participants characterized the stress they experienced as a result of their partners illness as "major." And 9 out of 10 said they found it difficult to keep the relationship going.

Building a team for supportMany people enter into relationships with a bipolar person unwittingly, thinking it will be smooth sailing, says Adele Viguera, MD, a psychiatrist at the Cleveland Clinic who works with bipolar couples seeking to start a family. "Maybe they meet the person when the person is hypomanic, not realizing that mood can change," she says.

Tim, 37, tried for three years to sustain a relationship with a woman eventually diagnosed with bipolar disorder. "She would cycle between extreme happiness and depression," he says, recalling her paranoia, impulsiveness, and self-destructive insecurity. "She broke up with me and started dating other people, and then when I dated other people she tried to win me back." Like many people with bipolar disorder, Tim's girlfriend also struggled with drug and alcohol addiction and got deep into debt—with his credit card. Tim eventually broke down emotionally himself, ended the affair, and tried to forget the experience. "Half of me moved on, but half of me will always love her," he says.

Divorce and separation are common in relationships involving bipolar disorder, but according to Dr. Viguera, such relationships don't have to be destructive and separation is hardly inevitable. Both parties have to participate in its success, however. "Taking care of bipolar disorder is a team effort, involving the two people and a psychiatrist or other mental health professional," she says. While she would never speak to a spouse without her patients consent, such open communication empowers both parties to make treatment decisions that lead to a healthier relationship.

Mental health professionals aren’t the only ones who can lend a hand. The stigma of mental illness can make couples hesitant to look elsewhere for help, but Karp emphasizes that extended family members and trusted friends can all provide invaluable support. "Spread it around a little bit," he says. "People need support systems. By keeping the illness a secret, people place an additional burden on themselves." Karp also recommends that anyone who cares for someone struggling with bipolar person find a support group in their area.

Bipolar marriages can work
Fred and Kristin Finn, of Grand Rapids, Mich., describe their marriage as loving and supportive, despite that fact that Kristin was diagnosed with bipolar disorder as a teenager. Their teenage daughter has also been diagnosed with the disorder.

The pillars of their success, both say, are open communication (Fred is free to reign in Kristin's clothes spending when he thinks she is manic) and predictable schedules. Kristin says carving time out for her own sleep is crucial, as is making time for each other. "We make sure that every Friday night we set aside time for each other,” she says. “Every single Friday night he comes home from work, we turn on some music, we sit, and we talk. My family and friends know—nobody calls us during that time period. Nothing can keep us away from our Friday night, because its our time to connect."

For his part, Fred says he would encourage anyone involved with a bipolar patient to educate themselves as much as they can about the disorder. You may not always like what you learn, he warns, but keeping surprises to a minimum makes your relationship easier to navigate. For example, he says, he is worried about the long-term effects of medication on Kristin's health. And while both his daughter and his wife comply with medication and therapy, neither is symptom-free.

"No matter what you're doing, there will be symptoms," Fred says. "Once I learned about how the symptoms manifest themselves, once I started reading that and becoming more familiar with that, it gave me a better understanding of how to cope with these things. Getting angry because a person has bipolar disorder won't help anything. Bipolar is treatable, medications and counseling help a great deal, but there's still things about bipolar disorder that I don't think I'll ever figure out."

This is a perfectly healthy stance to take, according to Karp. He urges people with bipolar partners to remember what he calls the "four Cs": I can't Control it; I didn't Cause it; I can't Cure it. All I can do is Cope with it.

“Out beyond ideas of wrongdoing and rightdoing there is a field. I'll meet you there.” ~ Rumi

Re: How to Care for and Cope With a Bipolar Spouse

...Chronic anger, anxiety, guilt, depression, or fear in one spouse can numb the other spouse to feelings in general. This emotional detachment is a survival mechanism to cope with the unstable emotional responses. The root cause of the initial emotion needs to be addressed before the other spouse is able to open up again...

“Out beyond ideas of wrongdoing and rightdoing there is a field. I'll meet you there.” ~ Rumi

Re: How to Care for and Cope With a Bipolar Spouse

My advice (mostly learned the hard way):

1. Avoid partnering with someone who thinks therapy is a waste of time.
2. Do not "engage" when being yelled at. Walk away.
3. If overspending is an issue, secretly save some money in a separate bank account just in case. This also gives you more freedom to leave the relationship or temporarily separate if need be.
4. Develop friendships and spend more time with your other family members. You will need them when the going gets tough.
5. Pick your battles but don't walk on eggshells.
6. Go to therapy yourself, especially if your support system is lacking or you have a disorder yourself.
7. Go on more "date nights" even if you have to encourage your spouse into doing so until it becomes routine.

“Out beyond ideas of wrongdoing and rightdoing there is a field. I'll meet you there.” ~ Rumi